1.1 Introduction
Infant feeding and weaning practices refer to the methods by which infants are nourished from birth through early childhood, particularly during the transition from exclusive breastfeeding to the introduction of complementary foods. According to the World Health Organization, optimal infant feeding involves exclusive breastfeeding for the first six months of life, followed by the gradual introduction of safe, adequate, and nutritionally appropriate complementary foods while continuing breastfeeding up to two years of age or beyond (WHO, 2021). Community Health Workers are frontline public health personnel who are trained to provide basic health education, preventive services, and community-based support, particularly at the primary healthcare level. They serve as a vital link between the healthcare system and the community, especially in underserved and rural areas where access to skilled health professionals is limited.
In maternal and child health, Community Health Workers play an important role in educating mothers on breastfeeding, complementary feeding, hygiene, and child care practices, thereby contributing to improved infant nutrition and survival (Perry et al., 2017). Their proximity to the community positions them to influence maternal behaviors, address misconceptions, and promote culturally acceptable health practices.
As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the aim and objectives of the study. Others are significance of the study, scope of work, research hypothesis and questions, limitation of the study and definition of terms.
1.2 Background of Study
Infant feeding and weaning practices have long been recognized as fundamental components of child health and nutrition, particularly during the first 1,000 days of life, which is a critical window for growth and development. According to the World Health Organization, appropriate infant feeding involves exclusive breastfeeding for the first six months of life and the timely introduction of nutritionally adequate and safe complementary foods while breastfeeding continues up to two years of age or beyond (WHO, 2021). Poor feeding and weaning practices during this sensitive period are strongly associated with malnutrition, weakened immunity, impaired cognitive development, and increased childhood morbidity and mortality, especially in developing countries (WHO, 2021).
Several scholars have emphasized the importance of community-based interventions in improving infant feeding outcomes. UNICEF (2022) reported that community-level nutrition education and support significantly improve breastfeeding initiation, exclusivity, and appropriate complementary feeding practices among mothers. In this context, Community Health Workers have emerged as key agents in promoting optimal infant feeding behaviors due to their close relationship with community members and their ability to provide culturally sensitive health education.
Perry et al. (2017) asserted that Community Health Workers play a vital role in translating national health policies into practical actions at the household level, particularly in underserved and rural communities. In Nigeria, infant feeding and weaning practices continue to present major public health challenges. According to the National Population Commission and ICF (2019), exclusive breastfeeding rates remain low, while inappropriate timing and poor quality of complementary feeding persist across many regions of the country. Researchers have attributed these challenges to factors such as maternal education, socio-cultural beliefs, economic constraints, and limited access to accurate health information. Ogunba (2020) stated that traditional norms and misinformation often influence mothers' feeding decisions more strongly than professional health advice, thereby undermining optimal feeding practices.
The role of Community Health Workers in addressing these challenges has been widely acknowledged. Bhutta et al. (2018) affirmed that trained Community Health Workers are effective in improving maternal knowledge and practices related to infant feeding and weaning through counseling, home visits, and community mobilization. However, the effectiveness of these workers is often constrained by inadequate training, insufficient supervision, limited resources, and heavy workloads.
On the same note, Kok et al. (2015) contend that without adequate institutional support and continuous capacity building, Community Health Workers may struggle to deliver consistent and high-quality nutrition education to mothers. Ogbomoso North Local Government Area of Oyo State represents a semi-urban setting where modern healthcare practices coexist with deeply rooted cultural traditions. Mothers in this area rely heavily on Community Health Workers for maternal and child health information, particularly at the primary healthcare level. Despite the presence of these workers, cases of poor infant feeding and inappropriate weaning practices remain evident, suggesting possible gaps between health education efforts and actual maternal practices. Ayanwale and Aluko (2021) reported that localized studies are necessary to understand the specific socio-cultural and systemic factors influencing infant feeding behaviors within different Nigerian communities. This study is set against the backdrop that this study seeks to assess how existing healthcare system structures influence the effectiveness of Community Health Workers in delivering nutrition education and supporting mothers to adopt recommended feeding practices.
1.3 Statement of Problems
Investigation revealed that appropriate infant feeding and timely weaning practices are critical determinants of child survival, growth, and overall development, particularly during the first two years of life. The World Health Organization recommends exclusive breastfeeding for the first six months of life, followed by the introduction of safe, adequate, and nutritionally appropriate complementary foods while continuing breastfeeding up to two years and beyond (WHO, 2021).
Furthermore, community Health Workers play a crucial role in bridging the gap between formal health systems and communities by providing health education, counseling, and support to mothers at the grassroots level. In rural and semi-urban areas such as Ogbomoso North Local Government Area, Community Health Workers are often the primary source of maternal and child health information. Their involvement in infant feeding and weaning promotion is expected to improve maternal knowledge, influence positive attitudes, and encourage healthy practices. However, evidence suggests that despite the presence of Community Health Workers, inappropriate feeding practices persist among many mothers (NPC & ICF, 2019). It is against this backdrop that this study seeks to assess how existing healthcare system structures influence the effectiveness of Community Health Workers in delivering nutrition education and supporting mothers to adopt recommended feeding practices.
1.4 Aim and Objectives of Study
The aim of the study is to assess the role of Community Health Workers in infant feeding and weaning promotion among mothers in Ogbomoso North Local Government Area. The specific objectives of this study are:
- To examine the extent to which Community Health Workers promote appropriate infant feeding and weaning practices among mothers.
- To identify challenges faced by Community Health Workers in the promotion of infant feeding and weaning.
- To determine the influence of Community Health Workers' activities on maternal feeding practices.
- To assess mothers' knowledge and practices regarding infant feeding and weaning.
- To evaluate the effectiveness of existing community-based infant nutrition programs.
1.5 Research Questions
The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:
- What roles do Community Health Workers play in promoting infant feeding and weaning practices among mothers in Ogbomoso North Local Government Area?
- What is the level of knowledge and practice of infant feeding and weaning among mothers in the study area?
- What challenges do Community Health Workers encounter in the promotion of infant feeding and weaning?
- How do the activities of Community Health Workers influence mothers' infant feeding and weaning practices?
- How effective are community-based programs in improving infant feeding and weaning practices?
1.6 Research Hypothesis
In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.
Hypothesis One
- H0: There is no significant association between mothers' exposure to Community Health Workers' nutrition education and their knowledge of infant feeding and weaning practices.
- H1: There is a significant association between mothers' exposure to Community Health Workers' nutrition education and their knowledge of infant feeding and weaning practices.
Hypothesis Two
- H0: There is no significant relationship between the activities of Community Health Workers and infant feeding and weaning practices among mothers in Ogbomoso North Local Government Area.
- H1: There is a significant relationship between the activities of Community Health Workers and infant feeding and weaning practices among mothers in Ogbomoso North Local Government Area.
1.7 Significance of Study
It is believed that at the completion of the study, the findings will benefit mothers and caregivers by improving access to accurate information on infant feeding and weaning practices. The study will also guide improvements in training, supervision, and deployment of Community Health Workers within the primary healthcare system.
Furthermore, the study will contribute to improved infant nutrition outcomes and reduced childhood malnutrition within Ogbomoso North Local Government Area. In addition, the study will benefit government and health policymakers by providing data that will guide the formulation of effective community-based nutrition policies.
Lastly, the study will assist healthcare institutions and primary healthcare centers by strengthening program planning and service delivery related to maternal and child health. The study will further contribute to academic institutions and researchers by serving as a reference material for future studies in community health and nutrition.
1.8 Scope of Study
The scope of this study is limited to Community Health Workers and mothers accessing services within primary healthcare centers under the Oyo State Primary Health Care Board in Ogbomoso North Local Government Area. The study focuses on infant feeding and weaning promotion and does not extend to other maternal or child health services.
1.9 Limitations of the Study
During the course of this study, many things militated against its completion, some of which are:
- Time Constraint: The time frame given to accomplish this project was very short due to school academic calendar and it was carried out under pressure which made the researcher not to implement some necessary features.
- Financial Constraint: Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).
1.10 Definition of Terms
Community Health Workers:
Community Health Workers are trained frontline health personnel who provide basic health education, preventive services, and community-based support within primary healthcare systems. According to Perry et al. (2017), they serve as a link between healthcare facilities and communities.
Infant Feeding:
Infant feeding refers to the methods used to nourish infants from birth, including breastfeeding and the use of appropriate complementary foods. The World Health Organization stated that optimal infant feeding promotes healthy growth and development (WHO, 2021).
Weaning:
Weaning is the gradual introduction of complementary foods alongside continued breastfeeding, typically from six months of age. UNICEF (2022) affirmed that proper weaning ensures adequate nutrition during early childhood.
Primary Health Care:
Primary healthcare is the first level of contact individuals have with the healthcare system, focusing on prevention, health promotion, and basic treatment services (WHO, 2018).
Mothers:
Mothers in this study refer to women who have infants or young children and utilize primary healthcare services for child health and nutrition support.
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